Service Delivery

Hepatitis B in the non-residential mentally handicapped population.

Devlin et al. (1993) · Journal of intellectual disability research : JIDR 1993
★ The Verdict

Hepatitis B hides in one out of nine non-residential adults with ID and creeps into their homes—check status and vaccinate.

✓ Read this if BCBAs serving adults or teens with ID who live with family.
✗ Skip if Clinicians working only with fully vaccinated preschoolers.

01Research in Context

01

What this study did

The team drew blood from adults with intellectual disability who lived at home.

They tested the blood for hepatitis B markers.

They also tested family members who lived in the same house.

02

What they found

One in nine adults carried hepatitis B.

One in three family members of a carrier also had markers.

The virus is common and spreads inside households.

03

How this fits with other research

Lin et al. (2010) and Yen et al. (2011) show the follow-up problem: only three out of four Taiwanese students with ID finish the hepatitis B shot series.

Ingham et al. (1992) give the good news: toddlers with Down syndrome make near-perfect antibodies after the vaccine.

Together the papers draw a clear line—high natural exposure, low vaccine uptake, but shots work when given.

04

Why it matters

You can’t see hepatitis B by watching behavior.

Add hepatitis B status to intake questions.

Ask about vaccine records at every care visit.

If the record is blank, refer for the shot series.

You will stop both liver disease and household spread.

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Pull the vaccine record of every adult client; if the hepatitis B series is missing, send the caregiver to the health clinic.

02At a glance

Intervention
not applicable
Design
survey
Population
intellectual disability
Finding
not reported

03Original abstract

This study describes seroprevalence and risk factors for hepatitis B in seven centres caring for non-residential mentally handicapped individuals. Overall, 11% were hepatitis B marker seropositive and 4% had the hepatitis B surface antigen (HBsAg). Male sex and increasing age were associated with seropositive status, and Down's syndrome was associated with the presence of HBsAg. Immediate family members of those with hepatitis B markers were screened and 22% had evidence of hepatitis B markers. Forty-one family members were identified when the mentally handicapped individual was HBsAg positive and of these 13 (32%) were seropositive. This study demonstrates that hepatitis B is a problem for the non-residential mentally handicapped population and confirms the risk of infection to their immediate families.

Journal of intellectual disability research : JIDR, 1993 · doi:10.1111/j.1365-2788.1993.tb00325.x